[Evaluation of the vascular endothelial growth factor in children and adolescents with type 1 diabetes]

Diabetes type 1 is the chronic disease, leading to many acute and late complications. Pathogenesis of the late complications is not fully understood. Lately, growth factors, and especially vascular endothelial growth factor (VEGF) are gaining great interest as potential risk factors of late diabetic complications, mainly nephropathy and retinopathy The aim of the study was evaluation of the level of VEGF in children and adolescents with diabetes type 1, and searching for correlation between level of this cytokine and microangiopathy and metabolic control.

68 young diabetic type patients were studied, aged 8-20 yrs (x = 15.54 yrs), suffering from diabetes type 1 from 2.3-16.5 yrs (x = 7.84 yrs), 34 boys, 34 girls. They were all under control of Outpatient Diabetic Department. Control group were healthy children, age and gender matched. Metabolic control was assessed on the basis of HbA1c level. All children underwent ophthalmology examination, microalbuminuria was evaluated in 24 hours urine samples. VEGF was estimated with use of immunoenzymatic method (RD Systems).

In the study group we found: significantly higher levels of VEGF compared to control group (328.68 +/- 251.6 vs 132.19 +/- 85.51 pg/ml: p<0.05). We did not find any differences between genders in VEGF level. VEGF increases with diabetes duration time, and the highest values are in children with diabetes duration over 10 years, although the differences did not reach statistical significance. VEGF level was significantly higher in children with poor metabolic control of the disease (406.65 +/- 322.11 pg/ml vs 132.19 +/- 85.51 pg/ml; p<0.05). Patients with retinopathy had the highest level of VEGF, compared to children without complications.

Assessment of VEGF level can be useful method in prognosis of diabetes microangiopathic complications. As microalbuminuria occurs relatively late in diabetic complications process, evaluation of VEGF may become a prognostic marker of the earliest phases of this complication.